What question did this study set out to answer?

To describe a novel surgical technique for endocardial left ventricular pacing lead implantation via a transapical approach when standard epicardial placement is hindered by pericardial adhesions.

April 19, 2008EP EuropaceOpen Access

New method for cardiac resynchronization therapy: transapical endocardial lead implantation for left ventricular free wall pacing

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Need for cardiac resynchronization therapy (n=1). Intervention: Transapical endocardial left ventricular lead implantation. Primary outcome: Feasibility and effective CRT with unchanged pacing parameters.

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Key result

Transapical endocardial left ventricular lead implantation was feasible and provided effective cardiac resynchronization therapy with unchanged pacing parameters at 6 months.

Why the study?

Is transapical endocardial left ventricular lead implantation feasible for cardiac resynchronization therapy?

Population

1 patient requiring cardiac resynchronization therapy with extensive pericardial adhesions preventing…

Design

Case_report

Follow-up

6 months

Authors

IKImre KassaiLeeds Teaching Hospitals NHS Trust CFCsaba FöldesiElectrophysiology ASAndrea SzékelySemmelweis University

Discussion

Member takes

Implication

May offer alternative LV access in select CRT patients; hypothesis-generating and requires prospective validation before practice change.

Key Points

To describe a novel surgical technique for endocardial left ventricular pacing lead implantation via a transapical approach when standard epicardial placement is hindered by pericardial adhesions.
Interventional surgical case report evaluating a single patient (N=1) undergoing cardiac resynchronization therapy.
Following thoracotomy and discovery of extensive pericardial adhesions, an active fixation lead was inserted directly into the left ventricular cavity through the apex using the Seldinger technique.
Assessed electrical performance, pacing parameters, and procedural safety during post-operative follow-up visits at 3 and 6 months.
Transapical entry enabled successful positioning and active fixation of the endocardial lead on the left ventricular free wall without acute complications.
Follow-up evaluations at 3 and 6 months demonstrated an uneventful clinical course with unchanged pacing parameters and effective cardiac resynchronization.

Study Design

Type

Case Report (n=1)

Structured PICO

Is transapical endocardial left ventricular lead implantation feasible for cardiac resynchronization therapy?

Population

1 patient requiring cardiac resynchronization therapy who underwent transapical endocardial left ventricular lead implantation due to extensive pericardial adhesions, followed for 6 months.

Intervention

Transapical endocardial left ventricular lead implantation using an active fixation lead placed into the LV cavity via the standard Seldinger technique through the LV apex

Outcome

Feasibility, post-operative recovery, and effective CRT with unchanged pacing parameters at 3- and 6-month follow-upsurrogate

This case report demonstrates the first-in-human feasibility of transapical endocardial left ventricular lead implantation for cardiac resynchronization therapy.

Cite This Study

Kassai et al. (2008) conducted a case report in Need for cardiac resynchronization therapy (n=1). Transapical endocardial left ventricular lead implantation was evaluated on Feasibility and effective CRT with unchanged pacing parameters. Transapical endocardial left ventricular lead implantation was feasible and provided effective cardiac resynchronization therapy with unchanged pacing parameters at 6 months.

synapsesocial.com/papers/6aa008d3d5d4327e77d55cc6 https://doi.org/10.1093/europace/eun090

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New method for cardiac resynchronization therapy: transapical endocardial lead implantation for left ventricular free wall pacing

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

New method for cardiac resynchronization therapy: transapical endocardial lead implantation for left ventricular free wall pacing

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

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